NATHANIEL CLARK P.A.
NPI 1063660074
Physician Assistant in Carbondale, IL

Q: What is Nathaniel Clark's NPI number?

The NPI number for Nathaniel Clark is 1063660074. It was assigned to this individual provider in the NPPES registry on September 3, 2008.

Q: What is Nathaniel Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nathaniel Clark was last updated on December 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 03, 2008PECOS EnrolledAccepts Medicare Assignment

75.73/100

CMS Quality Rating

409 W OAK ST, CARBONDALE, IL 62901(618) 529-4455(618) 351-1287 Get Directions Write a Review

NPPES record last updated: December 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 21, 2022, Oct 6, 2021, Oct 23, 2020 and 2 more (5 updates tracked since 2019).

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About Nathaniel Clark P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHANIEL CLARK P.A. (NPI 1063660074) is an individual physician assistant in Carbondale, Illinois, licensed in Illinois (085003278) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1063660074

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameNATHANIEL CLARKCredential: P.A.

Location Address409 W OAK STCarbondale, IL 62901-1464

Mailing Address409 W Oak StCarbondale, IL 62901-1464 · (618) 529-4555 · Fax (618) 351-1287

Phone(618) 529-4455

Fax(618) 351-1287

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateSeptember 3, 2008

Last NPPES UpdateDecember 21, 20225 updates tracked since enumeration

NPPES CertifiedDecember 21, 2022

✔ NPI 1063660074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085003278

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License 085-003278 (IL)

409 W OAK ST, Carbondale, IL 62901

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Secondary Practice Locations 3

Location 13905 W Ernestine DrMarion, IL 62959-5800 · Phone (618) 529-4455 · Fax (618) 351-1287

Location 2100 Dr Warren Tuttle DrHarrisburg, IL 62946-2718 · Phone (618) 529-4455 · Fax (618) 351-1287

Location 3217 S Park Ave Ste 2Herrin, IL 62948-3611 · Phone (618) 529-4455 · Fax (618) 351-1287

Other Identifiers 1

OtherP00657126IL · Railroad Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathaniel Clark P.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315015948

PECOS Enrollment IDI20081008000708

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

550 services397 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

438 services307 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

333 services245 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

154 services136 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

105 services84 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

57 services57 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number140184

Location3333 W DeyoungMarion, IL 62959 · Williamson County

Emergency services

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Crossroads Community Hospital

Acute Care Hospitals · Mount Vernon, IL

OwnershipProprietary

CMS Certification Number140294

Location8 Doctors Park RdMount Vernon, IL 62864 · Jefferson County

Emergency services

Ferrell Hospital Community Foundations

Critical Access Hospitals · Eldorado, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141324

Location1201 Pine StreetEldorado, IL 62930 · Saline County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.09

Promoting Interoperability

100

Improvement Activities

Cost

45.26

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDEEP BANGA M.D.

Internal Medicine (Interventional Cardiology)